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251 Georgia Street Vallejo CA 94590 | |
| (707) 558-8500 | |
| (707) 558-8508 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 251 Georgia Street, Vallejo, California |
| Authorized Official Name and Position | Rita Schank (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5102363139 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1901 Church Ln San Pablo CA 94806-3707 Ph: (510) 236-3139 | 251 Georgia Street Vallejo CA 94590 Ph: (707) 558-8500 |
| NPI Number | 1033326095 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 04/29/2020 |
| Certification Date | 04/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033326095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | 15-00005117 (California) | Secondary |
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